[Resolved] Oriental Insurance Company — Not paid full amount for my knee operation

tarunpahul

from Gurgaon, Haryana

Address:

Gurdaspur, Punjab, 143602

Dear Sir,
I am a retired employee from Punjab Roadways, Amritsar=2.Due to pain in my knees I consulted in OPD at Fortis Escort, Amritsar on 9.11.2016. They recommended for my knee replacement. With my consent Hospital sent a proposal to sanction amount for my knee replacement to Oriental Insurance as I was eligible for health insurance upto three lacs from 1/1/2016 to 31/12/2016. After a period of 39 days on 17/12/2016 Oriental Insurance sanctioned an amount of Rs. 1, 65, 648.00 for the purpose. Hospital admitted me and operated me on 20.12.2016 for knee replacement. Before discharging me on 26/12/2016, hospital lodged a bill no. IPCR82203 on 26-12-16 amounting Rs.2, 59, 366.00 for payment of balance amount i.e. (Rs.2, 59, 366 – Rs.1, 65, 648) Rs.93, 718.00. Oriental Insurance gave no response for the balance payment on the day. As I was to be discharged by the hospital on the very day, I helplessly paid the balance amount i.e. Rs. 93, 718.00 to the hospital and got myself discharged from the hospital. Since I am entitled for health insurance upto 3 lacs, Oriental Insurance was liable to pay full amount of bill i.e. Rs. 2, 59, 366.00. Hence, it is appealed that Oriental Insurance may kindly be directed to pay the amount of Rs. 93, 718.00 which is helplessly paid by me to the hospital.
With thanks,
Sincerely,
Sadhu Singh
S/o S. Buta Singh, Vill. Jangla, P/o Naserke
Teh. Batala, Distt. Gurdaspur
Contact No. [protected]

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Mar 10, 2017

Complaint marked as Resolved

Subject:--Nonpayment of balance medical claim amount by Oriental Insurance co. [ID: 1484836] Dear Sir, Kindly refer to my appeal dated 02/02/2017 against above insurance company on the subject cited above which was forwarded by your good self to the concerned company. After a long time of more than one Month needful is not done by the Oriental Insurance. It is again requested therefore to kindly look into the matter and directs the Oriental Insurance Co. to make the Payment of balance medical claimed amount i.e. 93718.00 at the earliest please. Thanks for this act of kindness and oblige? Sincerely Yours Sadhu Singh S/o S. Buta Singh Vill Jangla, Po Naserke, Teh Batala Distt. Gurdaspur, Phone : 9779164530

Oriental Insurance Company customer support has been notified about the posted complaint.